Provider Demographics
NPI:1467407973
Name:LIM-KYO, SHIELA-LYN MACATIAG (MS, NNP)
Entity Type:Individual
Prefix:MS
First Name:SHIELA-LYN
Middle Name:MACATIAG
Last Name:LIM-KYO
Suffix:
Gender:F
Credentials:MS, NNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 CALLERY COURT
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94539
Mailing Address - Country:US
Mailing Address - Phone:510-659-8883
Mailing Address - Fax:
Practice Address - Street 1:45 CALLERY CT
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94539-4756
Practice Address - Country:US
Practice Address - Phone:510-659-8883
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA494205163WN0002X
CANP 11312363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WN0002XNursing Service ProvidersRegistered NurseNeonatal Intensive Care
Not Answered363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA21WOtherPROVIDER NUMBER